If your child comes to you with a rash, don’t panic—not yet. Many childhood rashes are easy to treat or simply take time to clear up. Cindy Gellner, a pediatrician specializing in health at the University of Utah, says the five most common rashes she sees are:
- Eczema (atopic dermatitis)
- Molluscum contagiosum
- Pityriasis Alba
- Coxsackievirus (hand, foot, and mouth disease)
- diaper rashes
“There are many different types of eczema — intrinsic, flexural, dyshidrotic, nummular — but they’re all basically the same thing: an itchy, dry, scaly, often red rash that’s likely to affect people with allergies or asthma,” says Gellner.
Eczema is not contagious and can be treated with lotions for sensitive skin (no fragrances or dyes) or topical steroids such as hydrocortisone, or if severe, a prescription-strength steroid cream.
“Don’t use steroid creams regularly, as it can thin your skin, although eczema is often a lifelong condition,” says Gellner. “But without treatment, eczema can tear open the skin, which can lead to impetigo, a bacterial skin infection.”
“Molluscum contagiosum is a viral rash caused by the smallpox virus that usually occurs in young children through elementary school age,” says Gellner. “There is a white core in the center of the small flesh-colored papules. That’s essentially where the virus lives that eventually gets out. It basically looks like the little papule has a belly button.”
“Usually we just let this rash run its course because the treatment can be worse,” says Gellner. “The rash is actually harmless, but it is contagious. The body’s immune system will eventually kill the virus, although it may take months or even a few years.
“Pityriasis Alba is the loss of skin pigment from the melanin due to skin irritation,” says Gellner. “The cause can be as simple as dry skin, but it’s not caused by a vitamin deficiency as some families have feared, and it’s not contagious.”
The hypopigmented patches usually appear on the face, upper chest, upper back, and upper arms of people with dark skin.
“There’s nothing to make it better faster, but if you keep your skin hydrated, you might be able to avoid triggering more patches,” says Gellner. “The bottom line is you just have to wait for the skin cells to start pigmenting again.”
Coxsackievirus (hand, foot, and mouth disease)
“I always joke with the parents that it should be called hand, foot, mouth and mouth disease because that’s where the rash occurs,” says Gellner. “The classic are red papules on the palms and soles and on the buttocks. You can also get the rash around and in your mouth.”
“The coxsackievirus usually appears in the summer and fall, and the rash on the hands and feet is painless, although those in the mouth are painful,” says Gellner. “Keep kids hydrated but nothing will make it go away faster. It is also highly contagious, lasting about seven to 10 days.”
Diaper Rash (Candidal and Irritant)
“Yeast is normally on our skin, but a diaper is a dark, humid environment that can make yeast go a little crazy and cause candida diaper rash.” According to Gellner, moisture can also cause diaper irritation. She notes that babies can be swaddled often but still develop candida diaper rash.
“Candida diaper rashes have what are called satellite lesions; a red, bumpy rash, usually on the front, with small red bumps in the fringe area and down the legs. It is very itchy and can peel the skin if left untreated.”
Gellner says she also sees many children with normal diaper rashes caused by irritation, and she always tells her parents to just use diaper rash cream and change diapers frequently.
When to worry: Purple paint stains
So when do you need to worry? Gellner says you should act immediately if your child has what appears to be purple paint on their legs. “Like someone took a brush with dark purple paint and just sprayed it on, like tiny dots. This is bad and can be meningitis or idiopathic platelet purpura,” says Gellner. Both conditions require hospital treatment.
The body has a natural protective moisture barrier that helps keep harmful bacteria out. Too much bathing and chemicals can break it down.
“Kids don’t typically need a bath every day, let alone bath bombs,” says Gellner. “Some parents overdo the baths, and then their kids come in with dry, irritated skin and worry. It’s important to keep the body’s natural moisture barrier intact.”
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